Interventional radiology in pregnancy

The interventional radiologist may be called upon to play an extremely important role in the management of several obstetric and non-obstetric conditions during pregnancy. Although some procedures can be performed under local anesthetic, many interventional radiology procedures do require sedation. In keeping with modern practice, ultrasound should be used for procedural guidance whenever possible. Procedures such as chemical ablation of an ectopic pregnancy can be accomplished with the use of ultrasound alone. Venous thrombosis in both pregnant and non-pregnant patients is associated with a significant risk of post-thrombotic syndrome. Refractory primary and secondary postpartum hemorrhage due to uterine atony, retained products of conception, vaginal or uterine lacerations, or arterial injury can be managed with trans-arterial embolization of the uterine arteries or the anterior division of the internal iliac arteries. Besides the risks of exposure to sedation medications and radiation, it is important to have an awareness of possible complications from interventional procedures.